A review of graphical representations used in the dietary guidelines of selected countries in the Americas, Europe and Asia

Introduction: Food-Based Dietary Guidelines (FBDGs) are an initiative by the United Nations Food and Agriculture Organization (FAO) and the World Health Organization ('WHO) designed to help countries establish their own nutrition education principles. Such principles should be expressed through clear and specific messages that provide guidance and promote good health among populations. Many of these guidelines contain graphical representations (GRs) as visual aids for dietary guidance. Objectives: to analyze the characteristics of GRs used in various countries on four continents to identify international trends in these graphical messages and assess their usefulness as educational tools for their target populations. Methods: a review of GRs used in the FBDGs of countries in the Americas, Europe and Asia for which data were available in Spanish or English. Results and discussion: the models most used are the food circle and pyramid. The GRs (n=37) depict the following recommendations: food groups (37), physical activity (21), water intake (17), low salt intake (7), family meals (1) and relaxation (1). In addition, 10 quantitative recommendations were detected. The GRs of Greece and the United States do not show images of food. The aspects considered in the GRs vary by the regions, cultures and epidemiological characteristics of each country. A tendency to use the food circle and to include lifestyle recommendations in illustrations was observed in the United States, Spain and Mexico. Quantitative recommendations may help to clarify information provided during the educational process.